tbuckley/cabot-search huggingface dataset:
Uncovering heterogeneity in sepsis: a comparative analysis of subphenotypes
Authors: Rombout B. E. van Amstel, Jason N. Kennedy, Brendon P. Scicluna, Lieuwe D. J. Bos, Hessel Peters-Sengers, Joe M. Butler, Eddie Cano-Gamez, Julian C. Knight, Alexander P. J. Vlaar, Olaf L. Cremer, Derek C. Angus, Tom van der Poll, Christopher W. Seymour, Lonneke A. van Vught, Friso M. de Beer, Lieuwe D. J. Bos, Gerie J. Glas, Arie J. Hoogendijk, Roosmarijn T. M. van Hooijdonk, Janneke Horn, Mischa A. Huson, Laura R. A. Schouten, Marcus J. Schultz, Brendon P. Scicluna, Marleen Straat, Lonneke A. van Vught, Luuk Wieske, Maryse A. Wiewel, Esther Witteveen, Marc J. M. Bonten, Olaf M. Cremer, David S. Y. Ong, Jos F. Frencken, Peter M. C. Klein Klouwenberg, Maria E. Koster‐Brouwer, Kirsten van de Groep, Diana M. Verboom
Journal: Intensive Care Medicine (2023)

The heterogeneity in sepsis is held responsible, in part, for the lack of precision treatment. Many attempts to identify subtypes of sepsis patients identify those with shared underlying biology or outcomes. To date, though, there has been limited effort to determine overlap across these previously identified subtypes. We aimed to determine the concordance of critically ill patients with sepsis classified by four previously described subtype strategies.
COVID-19 Vaccination Prior to SARS-CoV-2 Infection Reduced Risk of Subsequent Diabetes Mellitus: A Real-World Investigation Using U.S. Electronic Health Records
Authors: Tina Yi Jin Hsieh, Renin Chang, Su-Boon Yong, Pei-Lun Liao, Yao-Min Hung, James Cheng-Chung Wei
Journal: Diabetes Care (2023)

Previous studies have indicated a bidirectional correlation between diabetes and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, no investigation has comprehensively explored the potential of coronavirus disease 2019 (COVID-19) vaccination to reduce the risk of new-onset diabetes in infected individuals.In the first of 2 cohorts, we compared the risk of new-onset diabetes between individuals infected with SARS-CoV-2 and noninfected individuals (N = 1,562,606) using the TriNetX database to validate findings in prior literature. For the second cohort, we identified 83,829 vaccinated and 83,829 unvaccinated COVID-19 survivors from the same period. Diabetes, antihyperglycemic drug use, and a composite of both were defined as outcomes. We conducted Cox proportional hazard regression analysis for the estimation of hazard ratios (HRs) and 95% CIs. Kaplan-Meier analysis was conducted to calculate the incidence of new-onset diabetes. Subgroup analyses based on age (18-44, 45-64, ≥65 years), sex (female, male), race (White, Black or African American, Asian), and BMI categories (<19.9, 20-29, 30-39, ≥40), sensitivities analyses, and a dose-response analysis were conducted to validate the findings.The initial cohort of patients infected with SARS-CoV-2 had a 65% increased risk (HR 1.65; 95% CI 1.62-1.68) of developing new-onset diabetes relative to noninfected individuals. In the second cohort, we observed that vaccinated patients had a 21% lower risk of developing new-onset diabetes in comparison with unvaccinated COVID-19 survivors (HR 0.79; 95% CI 0.73-0.86). Subgroup analyses by sex, age, race, and BMI yielded similar results. These findings were consistent in sensitivity analyses and cross-validation with an independent data set from TriNetX.In conclusion, this study validates a 65% higher risk of new-onset diabetes in SARS-CoV-2-infected individuals compared to noninfected counterparts. Furthermore, COVID-19 survivors who received COVID-19 vaccinations experienced a reduced risk of new-onset diabetes, with a dose-dependent effect. Notably, the protective impact of COVID-19 vaccination is more pronounced among the Black/African American population than other ethnic groups. These findings emphasize the imperative of widespread vaccination to mitigate diabetes risk and the need for tailored strategies for diverse demographic groups to ensure equitable protection.
Explanation of Error in “Effect of Brief Counseling by Allied Health Professionals on Step Count of People With Peripheral Artery Disease: A Randomized Clinical Trial”
Authors: Jonathan Golledge, Alkira Venn, Joseph V. Moxon
Journal: JAMA Cardiology (2023)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Cardiology HomeNew OnlineCurrent IssueFor Authors Podcast Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2024 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Cardiology journal
Navigating the Path to Effective, Equitable, and Evidence-Based Telehealth for Opioid Use Disorder Treatment
Authors: Lindsay D. Allen
Journal: JAMA Network Open (2023)

Lindsey R. Hammerslag, PhD; Aimee Mack, MPH; Redonna K. Chandler, PhD; Laura C. Fanucchi, MD, MPH; Daniel J. Feaster, PhD; Marc R. LaRochelle, MD, MPH; Michelle R. Lofwall, MD; Michael Nau, PhD; Jennifer Villani, PhD, MPH; Sharon L. Walsh, PhD; Philip M. Westgate, PhD; Svetla Slavova, PhD; Jeffery C. Talbert, PhD
Exercise‐based cardiac rehabilitation for adults with heart failure – 2023 Cochrane systematic review and meta‐analysis
Authors: Cal D. Molloy, Linda Long, Ify R. Mordi, Charlene Bridges, Viral A. Sagar, Edward J. Davies, Andrew J.S. Coats, Hasnain Dalal, Karen Rees, Sally J. Singh, Rod S. Taylor
Journal: European Journal of Heart Failure (2023)

Abstract Aims Despite strong evidence, access to exercise‐based cardiac rehabilitation (ExCR) remains low across global healthcare systems. We provide a contemporary update of the Cochrane review randomized trial evidence for ExCR for adults with heart failure (HF) and compare different delivery modes: centre‐based, home‐based (including digital support), and both (hybrid). Methods and results Databases, bibliographies of previous systematic reviews and included trials, and trials registers were searched with no language restrictions. Randomized controlled trials, recruiting adults with HF, assigned to either ExCR or a no‐exercise control group, with follow‐up of ≥6 months were included. Two review authors independently screened titles for inclusion, extracted trial and patient characteristics, outcome data, and assessed risk of bias. Outcomes of mortality, hospitalization, and health‐related quality of life (HRQoL) were pooled across trials using meta‐analysis at short‐term (≤12 months) and long‐term follow‐up (&gt;12 months) and stratified by delivery mode. Sixty trials (8728 participants) were included. In the short term, compared to control, ExCR did not impact all‐cause mortality (relative risk [RR] 0.93; 95% confidence interval [CI] 0.71–1.21), reduced all‐cause hospitalization (RR 0.69; 95% CI 0.56–0.86, number needed to treat: 13, 95% CI 9–22), and was associated with a clinically important improvement in HRQoL measured by the Minnesota Living with Heart Failure Questionnaire (MLWHF) overall score (mean difference: −7.39; 95% CI −10.30 to −4.47). Improvements in outcomes with ExCR was seen across centre, home (including digitally supported), and hybrid settings. A similar pattern of results was seen in the long term (mortality: RR 0.87, 95% CI 0.72–1.04; all‐cause hospitalization: RR 0.84, 95% CI 0.70–1.01, MLWHF: −9.59, 95% CI −17.48 to −1.50). Conclusions To improve global suboptimal levels of uptake for HF patients, global healthcare systems need to routinely recommend ExCR and offer a choice of mode of delivery, dependent on an individual patient's level of risk and complexity.
Characteristics of Recurrent Visions of the Nonphysical World Among Cognitively Unimpaired Elders of an Ojibwe Tribal Nation
Authors: William G. Mantyh, Adam D. Block, Madelyn R. Castro, Adam Hansen, Matti J. Matheson, Corey Strong, Annamarie Hill, Zuzan Cayci, J. Neil Henderson
Journal: JAMA Network Open (2023)

Importance Visual hallucinations are a core feature of dementia with Lewy bodies and primary psychiatric disease, yet identification of a hallucination vs normal spiritual experience depends on cultural context. Almost no information exists in the medical literature regarding normal spiritual experiences in American Indian participants in the context of a neurocognitive evaluation. Objective To assess the characteristics of a normal spiritual experience in an Ojibwe Tribal Nation. Design, Setting, and Participants This prospective, cross-sectional study was conducted between August 1, 2021, and August 31, 2022, among an Ojibwe Tribal Nation in northern Minnesota. Participants were evaluated at their tribal nation clinic. Cognitively unimpaired tribal Elders who were enrolled members of the tribal nation and aged 55 years or older were invited to participate via fliers, radio advertisements, and health fair presentations. Thirty-seven tribal Elders volunteered. Main Outcomes and Measures Each participant was asked whether they experienced hallucinations or visions of people, animals, or objects that are not part of the physical world. This was an a priori formulated question and part of a comprehensive neurocognitive evaluation consisting of history and physical examination (including cognitive screening with a subspecialty-trained behavioral neurologist); blood tests for metabolic, nutritional, and thyroid conditions; and noncontrast magnetic resonance imaging brain scan. Four patients were excluded from the present analysis due to having mild cognitive impairment or dementia. Results Thirty-three cognitively unimpaired tribal Elders (mean [SD] age, 66.0 [7.5] years; 22 women [67%]) were included. Sixteen (48%) answered affirmatively, reporting recurrent visions of the nonphysical world. Generally, these visions were well formed, benevolent in nature, and transient; started in preadolescence; involved spirits or ancestors; and were congruent with cultural and spiritual beliefs of the Ojibwe people. No patients had accompanying dream enactment behavior, dysautonomia, parkinsonism, sleep transition–related hallucinations, or moderate to severe depression to suggest a prodrome of an α-synucleinopathy, hypnopompic or hypnagogic hallucinations, or psychosis. Conclusions and Relevance Although based on only 1 Ojibwe Tribal Nation, this study suggests that formed visions of the nonphysical world are common among cognitively healthy Ojibwe individuals and can represent normal spiritual experiences. Clinicians would benefit from careful consideration of cultural or spiritual context to avoid misdiagnosis of neuropsychiatric disease.
Early Left Ventricular Unloading or Conventional Approach After Venoarterial Extracorporeal Membrane Oxygenation: The EARLY-UNLOAD Randomized Clinical Trial
Authors: Min Chul Kim, Yongwhan Lim, Seung Hun Lee, Yoonmin Shin, Joon Ho Ahn, Dae Young Hyun, Kyung Hoon Cho, Doo Sun Sim, Young Joon Hong, Ju Han Kim, Myung Ho Jeong, Yong Hun Jung, In-Seok Jeong, Youngkeun Ahn
Journal: Circulation (2023)

Although venoarterial extracorporeal membrane oxygenation (VA-ECMO) is beneficial for the treatment of profound cardiogenic shock, peripheral VA-ECMO cannulation can increase left ventricular afterload, thus compromising myocardial recovery. We investigated whether early routine left ventricular unloading can reduce 30-day mortality compared with the conventional approach in patients with cardiogenic shock undergoing VA-ECMO.
The Patient Experience of Prior Authorization for Cancer Care
Authors: Fumiko Chino, Alexandra Baez, Ivy B. Elkins, Emeline M. Aviki, Lauren V. Ghazal, Bridgette Thom
Journal: JAMA Network Open (2023)

Prior authorization (PA) requires clinicians and patients to navigate a complex approval pathway. Resultant delays and denials can be particularly problematic for patients with cancer, who often need urgent treatment or symptom management.To investigate the patient perspective of PA for cancer-related care, including perceptions about the process, outcomes (including delays and denials), and patient administrative burden.This cross-sectional, anonymous survey used a convenience sample of patients with PA experience. Participants were recruited using social media and email lists of US-based cancer advocacy organizations from July 1 to October 6, 2022.Prior authorization for any cancer-related service.Delays to care, outcome of PA, communication, and changes in anxiety (measured on a scale of 0-100, with 0 indicating no anxiety and higher scores indicating higher levels of anxiety) and trust.Of 178 respondents (158 women [88%], 151 non-Hispanic White respondents [84%], 164 respondents [92%] <65 years), 112 (63%) reported that their cancer care was approved and given as recommended, and 39 (22%) did not receive recommended care due to delays or denials. Most respondents (123 [69%]) reported a PA-related delay in care; of those with delayed care, 90 (73%) reported a delay of 2 or more weeks. Most respondents (119 [67%]) had to personally become involved in the PA process; 35 (20%) spent 11 or more hours dealing with PA issues. Overall, the PA experience was rated as bad (70 [40%]) or horrible (55 of 174 [32%]); ratings were associated with the length of delay (ρ = 0.36; P < .001) and the time spent on PA (ρ = 0.42; P < .001). Self-reported PA-related anxiety was higher than usual anxiety (mean [SD] score, 74.7 [20.2] vs 37.5 [22.6]; P < .001) and was correlated with delay length (ρ = 0.16; P = .04), time spent on PA (ρ = 0.27; P < .001), and overall PA experience (ρ = 0.34; P < .001). After PA, 159 respondents (89%) trusted their insurance company less, and 148 respondents (83%) trusted the health care system less. Patient involvement in the PA process was associated with increased odds of distrusting their insurance company (β = 6.0; 95% CI, 1.9-19.2) and the health care system (β = 3.3; 95% CI, 1.4-8.1) and of having a negative experience (β = 6.6; 95% CI, 3.1-14.3).This survey-based cross-sectional study of the patient experience with PA highlights an adverse outcome of PA: 22% of patients did not receive the care recommended by their treatment team because of PA. Most respondents experienced a delay in recommended oncology care, and delays were associated with increased anxiety, a negative perception of the PA process, and patient administrative burden.
KRT17high/CXCL8+ Tumor Cells Display Both Classical and Basal Features and Regulate Myeloid Infiltration in the Pancreatic Cancer Microenvironment
Authors: Eileen S. Carpenter, Padma Kadiyala, Ahmed M. Elhossiny, Samantha B. Kemp, Jay Li, Nina G. Steele, Rémy Nicolle, Zeribe C. Nwosu, Julia Freeman, Henry Dai, Daniel Paglia, Wenting Du, Katelyn Donahue, Jacqueline Morales, Paola I. Medina-Cabrera, Monica E. Bonilla, Lindsey Harris, Stephanie The, Valerie Gunchick, Nicole Peterson, Kristee Brown, Michael Mattea, Carlos E. Espinoza, Jake McGue, Sarah M. Kabala, Rachel K. Baliira, Nur M. Renollet, Ayden G. Mooney, Jianhua Liu, Sean Bhalla, Jeremy P. Farida, Christopher Ko, Jorge D. Machicado, Richard S. Kwon, Erik-Jan Wamsteker, Allison Schulman, Michelle A. Anderson, Ryan Law, Anoop Prabhu, Pierre A. Coulombe, Arvind Rao, Timothy L. Frankel, Filip Bednar, Jiaqi Shi, Vaibhav Sahai, Marina Pasca Di Magliano
Journal: Clinical Cancer Research (2023)

Abstract Purpose: Pancreatic ductal adenocarcinoma (PDAC) is generally divided in two subtypes, classical and basal. Recently, single-cell RNA sequencing has uncovered the coexistence of basal and classical cancer cells, as well as intermediary cancer cells, in individual tumors. The latter remains poorly understood; here, we sought to characterize them using a multimodal approach. Experimental Design: We performed subtyping on a single-cell RNA sequencing dataset containing 18 human PDAC samples to identify multiple intermediary subtypes. We generated patient-derived PDAC organoids for functional studies. We compared single-cell profiling of matched blood and tumor samples to measure changes in the local and systemic immune microenvironment. We then leveraged longitudinally patient-matched blood to follow individual patients over the course of chemotherapy. Results: We identified a cluster of KRT17-high intermediary cancer cells that uniquely express high levels of CXCL8 and other cytokines. The proportion of KRT17high/CXCL8+ cells in patient tumors correlated with intratumoral myeloid abundance, and, interestingly, high protumor peripheral blood granulocytes, implicating local and systemic roles. Patient-derived organoids maintained KRT17high/CXCL8+ cells and induced myeloid cell migration in a CXCL8-dependent manner. In our longitudinal studies, plasma CXCL8 decreased following chemotherapy in responsive patients, while CXCL8 persistence portended worse prognosis. Conclusions: Through single-cell analysis of PDAC samples, we identified KRT17high/CXCL8+ cancer cells as an intermediary subtype, marked by a unique cytokine profile and capable of influencing myeloid cells in the tumor microenvironment and systemically. The abundance of this cell population should be considered for patient stratification in precision immunotherapy. See related commentary by Faraoni and McAllister, p. 2297
Extensive Perineural Invasion vs Nerve Caliber to Assess Cutaneous Squamous Cell Carcinoma Prognosis
Authors: Paul R. Massey, David M. Wang, Fadi Murad, Patrick Mulvaney, Kevin Moore, Jean-Phillip Okhovat, Eleanor Russell-Goldman, William M. Lin, Adriano Piris, Shyamala C. Huilgol, Emily S. Ruiz, Chrysalyne D. Schmults
Journal: JAMA Dermatology (2023)

Perineural invasion (PNI) is an adverse risk feature in cutaneous squamous cell carcinoma (CSCC) that affects patient prognosis and disease management. However, research comparing different PNI patterns on patient outcomes is limited.
Janus Kinase Inhibitors and Adverse Events of Acne
Authors: Jeremy Martinez, Cyriac Manjaly, Priya Manjaly, Sophia Ly, Guohai Zhou, John Barbieri, Arash Mostaghimi
Journal: JAMA Dermatology (2023)

Janus kinase (JAK) inhibitors are increasingly used across a range of dermatologic conditions. Adverse events of acne have been noted in some studies in clinical practice, but the scope of this outcome across JAK inhibitors has not been established.
Vaccination Hesitancy Increasing Among Pregnant Women
Authors: Emily Harris
Journal: JAMA (2023)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Effect of donor age in patients with <scp>acute myeloid leukemia</scp> undergoing haploidentical <scp>hematopoietic cell transplantation</scp> vary by conditioning intensity and recipient age
Authors: Rima M. Saliba, Christopher G. Kanakry, Shahinaz Gadalla, Partow Kebriaei, Katayoun Rezvani, Richard E. Champlin, Elizabeth J. Shpall, Daniel Weisdorf, Rohtesh S. Mehta
Journal: American Journal of Hematology (2023)

We investigated the impact of donor age (younger [≤35 years] vs. older [>35 years]) after accounting for other non-HLA and HLA factors on outcomes of patients with acute myeloid leukemia undergoing HLA-haploidentical hematopoietic cell transplantation (n = 790). The effect differed by conditioning-partly related to the differences in the recipient age in myeloablative (MAC; median 46 years) versus reduced-intensity/non-myeloablative conditioning (RIC/NMA; median 61 years) groups. With MAC (n = 320), donor age had no impact on acute graft-versus-host disease (GVHD), but older donors were associated with a significantly higher risk of chronic GVHD (hazard ratio [HR]: 1.6, 95% confidence interval [CI]: 1.10-2.30, p = .02) independent of recipient age and other factors. Donor age had no impact on either relapse or non-relapse mortality (NRM). The impact of donor/recipient age on overall survival changed over time. Older donors were associated with significantly higher late overall mortality (>6 months) in younger recipients (≤ 50 years; HR: 2.2, 95% CI: 1.03-4.6, p = .04) but not older recipients. With RIC/NMA (n = 470), neither recipient's nor donor's age influenced the risk of GVHD. Donor age had no significant impact on the risk of relapse, but older donors were associated with a significantly higher risk of NRM (HR: 1.6, 95% CI: 1.02-2.6, p = .04) independent of recipient age. Older donor age was associated with significantly higher late overall mortality (>9 months) in older recipients (>50 years; HR: 1.66, 95% CI: 1.0-2.67; p = .049) but not in younger recipients. Donor selection based on donor age may require a tailored approach for a particular recipient.
Cellular Heterogeneity of Activated Primary Human Macrophages and Associated Drug–Gene Networks: From Biology to Precision Therapeutics
Authors: Julius L. Decano, Enrico Maiorino, Joan T. Matamalas, Sarvesh Chelvanambi, Bart M. Tiemeijer, Yoshihiro Yanagihara, Shin Mukai, Prabhash Kumar Jha, Diego V.S. Pestana, Edwin D’Souza, Mary Whelan, Rile Ge, Takaharu Asano, Amitabh Sharma, Peter Libby, Sasha A. Singh, Elena Aikawa, Masanori Aikawa
Journal: Circulation (2023)

Interferon-γ (IFNγ) signaling plays a complex role in atherogenesis. IFNγ stimulation of macrophages permits in vitro exploration of proinflammatory mechanisms and the development of novel immune therapies. We hypothesized that the study of macrophage subpopulations could lead to anti-inflammatory interventions.
Anifrolumab for Adolescent Discoid Lupus Erythematosus
Authors: Katharina S. Shaw, Ahmad Rajeh, Todd Le, Philip J. Kahn, Vikash S. Oza, Lisa M. Arkin, Ruth Ann Vleugels
Journal: JAMA Network Open (2023)

This case series describes the outcomes among adolescent patients with systemic lupus erythematosus and refractory discoid lupus erythematosus treated with anifrolumab.